A COMPARISON OF MORBIDITY ASSOCIATED WITH PLACENTA PREVIA WITH AND WITHOUT PREVIOUS CAESAREAN SECTIONS
Morbidity Associated With Placenta Previa
Keywords:Caesarean, Hysterectomy, Placenta previa, Placenta
Objective: To compare the morbidity associated with placenta previa with and without previous caesarean
Study Design: Retrospective comparative study.
Place and Duration of Study: From March 2014 till March 2016 in the department of Obstetrics and Gynaecology
at PNS Shifa hospital Karachi.
Material and Methods: After the approval from hospital ethical committee, antenatal patients with singleton
pregnancy of gestational age >32 weeks, in the age group of 20-40 years diagnosed to have placenta previa
included in the study. All patients with twin pregnancy less than 20 years and more than 40 years of age were
excluded. The records of all patients fulfilling the inclusion criteria were reviewed. Data had been collected for
demographic and maternal variables, placenta previa, history of previous lower segment caesarean section
(LSCS), complications associated with placenta previa and techniques used to control blood loss were recorded.
Results: During the study period, 6879 patients were delivered in PNS Shifa, out of these, 2060 (29.9%) had
caesarean section out of these, 47.3% patients had previous history of LSCS. Thirty three (1.6%) patients were
diagnosed to have placenta previa and frequency of placenta previa was significantly higher in patients with
previous history of LSCS than previous normal delivery of LSCS i.e. 22 vs. 11 (p=0.023). It was observed that the
frequency of morbidly adherent placenta (MAP) and Intensive care unit (ICU) stay were significantly higher in
patients with previous history of LSCS than previous history of normal delivery.
Conclusion: Frequency of placenta previa was significantly higher in patients with history of LSCS. Also placenta
previa remains a major risk factor for various maternal complications.